Dietary risk markers that contribute to the aetiology of hypertension in black South African children: the THUSA BANA study

Abstract

Although clinical hypertension occurs less frequently in children than in adults, ample evidence supports the concept that the roots of essential hypertension extend back to childhood. Since little is available in the literature on causal dietary factors of hypertension in children, this study hypothesised that certain dietary factors can be identified as risk markers that might contribute to the aetiology of hypertension in black children. Children aged 10-15 years were randomly selected from 30 schools in the North West Province from 2000 to 2001. These children comprised 321 black males and 373 females from rural to urbanised communities, of which 40 male and 79 female subjects were identified with high-normal to hypertensive blood pressure. Blood pressure was measured with a Finapres apparatus and data were analysed with the Fast Modelflo software program to provide systolic, diastolic and mean blood pressure. A 24-h dietary recall questionnaire and weight and height measurements were taken.In a stepwise regression analysis, the following variables were significantly associated (Pp0.05) with blood pressure parameters of hypertensive males: biotin, folic acid, pantothenic acid, zinc and magnesium. Energy, biotin and vitamin A intakes were significantly associated with blood pressure parameters of hypertensive females. No significant dietary markers were indicated for any of the normotensive groups. Dietary intakes of all of these nutrients were well below the dietary reference intakes. In conclusion, the dietary results coupled with the cardiovascular parameters of this study identified folic acid and biotin as risk markers that could contribute to the aetiology of hypertension in black persons. The low intakes of these nutrients, among others, is a matter of serious concern, as is the increasing tendency towards urbanisation.

The risk factors for elevated blood pressure and how to address cardiovascular risk factors: a review in paediatric populations

“…The prevalence of hypertension in sub-Saharan Africa ranged 0-12.5% for boys and 0-21.5% for girls ( Table 1). The highest prevalence rate recorded was 21.5% 31 for girls and 12.5% for boys, 32 whereas Steyn et al 30 recorded the highest total prevalence rate of 22.3% for both boys and girls in urban South African children. Misra et al 19 recorded the highest (20.0%) prevalence of BP for boys in the Asian region followed by Smith and Rinderknecht 14 in the United Staes (13.2%).…”

“…In general, the studies cited in this review classified the children as hypertensive based on the the guidelines for hypertension. 12,13,31,32,30,[33][34][35] Frontini et al 24 and Barger and Muldoon 25 classified children as hypertensive based on the 140/90 mm Hg recommendation of the WHO. It is clear from the cutoff point of these two studies together with the study of van der Sande et al 22 who used 160/95 mm Hg that the situation might be worse than it is reported in their respective area.…”

Validation of the Finometer device for measurement of blood pressure in black women

“…1 For a few decades, noninvasive finger arterial BP measurement (Finapres/ Portapres) has become an accepted technology, widely used in different areas of research, ranging from basic research, such as autonomic control of cardiovascular function, hypertension, pharmacology and psychophysiology, to use in the operating room, clinical practice, aero-and space research. [2][3][4] It has been shown that the vascular unloading technique of Penáz together with the Physiocal criteria of Wesseling provides reliable, noninvasive and continuous estimates of BP. [5][6][7] However, previous studies 7 have indicated that although the Finapres fulfilled the accuracy requirements for the mean and diastolic mean difference (+1.7 mmHg (s.d.…”

Índice de massa corpórea, sobrepeso e pressão arterial em escolares na província de Limpopo, África do Sul

“…The prevalence of hypertension found (29) , others almost similar values (13,30) , while a majority of the studies had disproportionately higher prevalence rates of hypertension (Table 5). (1,12,13,(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37) The likely reasons for the difference between the prevalence of hypertension in this study and those reported in the literature might be the use of different age groups, differing research methods and definitions of BP, as well as differences in reported prevalence and risk estimates. It is possible too, that geographical location may account for the difference in distribution of BP.…”

“…Monyeki et al (32) Tunisia 15-19 5.2 Aounalian-Skhiri et al (33) South Africa 10-15 17.2 Schutte et al (34) New Delhi 14-25 20.0 (boys)…”